Provider Demographics
NPI:1922377217
Name:JACOBS, NANCY EVE (AUD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:EVE
Last Name:JACOBS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 DOROTHY DR
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-1812
Mailing Address - Country:US
Mailing Address - Phone:718-794-7244
Mailing Address - Fax:718-794-7435
Practice Address - Street 1:3450 E TREMONT AVE
Practice Address - Street 2:ROOM 227
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-2020
Practice Address - Country:US
Practice Address - Phone:718-794-7244
Practice Address - Fax:718-794-7435
Is Sole Proprietor?:No
Enumeration Date:2011-12-15
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1301231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist